1.Study on the association between general surgeon volume, professional skill and surgery outcome
Janchiv J ; Lkhagvasuren TS ; Tseden P ; Sergelen O
Mongolian Medical Sciences 2014;170(4):49-54
Background: Several researchers had been previously done the health professional workload study,however, because of the lack of studies of the relationship between physicians’ volume and outcome, wedid not have enough evidence of the resource allocation, the surgery outcome and quality improvementin our country.Goal: The study was aimed to study general surgeon volume and surgery outcome.Materials and Methods: We randomly selected 1147 patients diagnosed with gallbladder disease whounderwent laparoscopic cholecystectomy (LC) and acute appendicitis from 2012-2013 at the First andThird Clinical hospital and Khovd province Regional Diagnostic and Treatment Center were included.Patient demographics and clinical information, such as drug cost, duration of surgery, and name ofsurgeons were derived from patient medical records. Surgeons’ information, such as age, gender,professional and academic degree, and work experience were derived from hospital human resourcedepartment and correlation analysis was performed to examine the association between surgeryduration, surgeon experience and drug cost.Results: Hospitals LC was done 51,3±32,8 minutes with 24900,70 tugriks, appendectomy was done52,7±31,4 minutes with 18361,00 tugriks of drug cost. The Third Clinical hospital surgeons operatedhigher costs (28631,34±16985,86tugriks) and shorter time (39,86±39,54 ìèí) of an appendectomy. Butthe First Clinical hospital surgeons incurred lower cost (8460,82±13231,40 tugriks) of appendectomy.However, there were no significant differences in operation time and drug average cost in appendectomyin terms of positive and weak correlation(r<0.5, p>0.05). Conclusion: General surgeon volume was notassociated with surgery outcome.
2. Assessment of biliary complication after liver transplantation in Mongolia
Bat-Ireedui B ; Ganzorig B ; Batsaikhan B ; Erdene S ; Batchuluun P ; Amgalan L ; Sergelen O
Journal of Surgery 2016;19(1):10-18
Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.
3. RESULT OF KASAI OPERATION, CHILDREN LIVER TRANSPLANTATION IN MONGOLIA
Chuluunkhuu D ; Zorigtbaatar M ; Nurjanar R ; Ganbayr L ; Otgonsuren G ; Dashaa M ; Enkhzul P ; Khandmaa B ; Sergelen O ; Bat-Ireedui B ; Ganzorig B ; Pagaldulam M ; Saruul G ; Tsendjav A
Journal of Surgery 2016;20(2):56-61
Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.
4.Postpartum readmission rate
Odonzul Ts ; Batbold Ts ; Ariuntsetseg J ; Sergelen P ; Hangal Sh ; Ganbold S ; Munkh-Erdene L ; Erkembaatar T
Mongolian Medical Sciences 2020;193(3):28-34
Background:
Postpartum readmission rate has been increasing after both caesarean and vaginal delivery.
Postpartum diseases, in some cases with infection and anemia, result in hospital readmission. Also
it raises the issue associated with maternal hospital’s healthcare quality. There has lack of study
focusing on postpartum readmission. So we will study postpartum readmission rate.
Material and Methods:
112 patients who readmitted in Amgalan maternity hospital in Ulaanbaatar were involved in this study.
We used patient’s medical history to determine risk factors resulted in hospital readmission after
caesarean and vaginal therapy.
Results:
The mean age of women delivered by cesarean was 30.2±7.32 and vaginal delivery’s was 28.3±7.21.
34.8 percent of women who readmitted after vaginal delivery had 1-3 readmission days and 56.5
percent was 4-6 days and 8.7 percent was 7-10 days. Readmission day for women delivered
by caesarean was 1-3 days in 21.2 percent of these, 4-6 days in 56.1 percent and 7-10 days in
19.7 percent. The mean readmission day of women delivered by vaginal delivery was 4.73±1.61
(mean±SD) and the mean of women delivered by caesarean delivery was 5.54±2.34 (mean±SD). In
each category, there had 24.2-28.3 percent cases with lochia. Women who had caesarian delivery
were infected their scar with 24(36.3) cases. Renal urinary system infection had in 12(26.0) women
delivered by vaginal delivery.
Conclusion
58.9 percent of total readmissions cases were caesarean and 41.1 percent was vaginal delivery.
Lochia and renal urinary infection had influence in readmission after vaginal delivery. Also both lochia
and infected wound impacted on postpartum readmission after caesarian delivery.